This feature is available to Subscribers Only

An 86-year-old woman presented to the pulmonology department following a 4-month history of a progressive nonproductive cough, wheezing, and exertional dyspnea. A plain-film chest radiograph demonstrated a foreign body in the lower lobe of her right lung (image A). Symptoms began 1 week after a tooth extraction, during which a gold crown on an adjacent tooth was dislodged and presumably ingested. Chest computed tomography confirmed a foreign body in the basal segment of the right lower lobe. Subsequent flexible bronchoscopy revealed a metallic-appearing object in the right bronchus intermedius (image B), which was successfully extracted via bronchoscopy using a basket instrument for renal stones.

Tracheobronchial foreign body aspiration is a rare occurrence among adults.1,2 Clinical manifestations of distal airway obstruction include chronic cough, fever, hemoptysis, chest pain, and wheezing, which can be further complicated by postobstructive pneumonia and atelectasis.1,3 Flexible bronchoscopy serves as a diagnostic and therapeutic modality in the management of lower airway obstruction.1,4